Diagnostic Testing

Diagnostic testing for thoracolumbar conditions is similar to that for the cervical spine. Plain radiographs (AP, lateral, and oblique views) can be obtained (Fig. 31-15). CT, MRI, or myelography may be indicated in patients with worsening neurologic deficits or a suspected systemic cause of back pain, such as infection or neoplasm. These imaging studies are also useful when referral for surgery is considered.

Table 31-2 Normal Range of Movement: Thoracolumbar Spine

Motion

Range

Flexion

0-80 degrees

Extension

0-20 degrees

Lateral bend

0-35 degrees

Rotation

0-45 degrees

Modified from Carr AJ, Harnden A. Orthopedics in Primary Care. Newton, Mass, Butterworth-Heinemann, 1997.

Figure 31-13 Bowstring sign. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 365.)
Figure 31-14 Femoral nerve stretch test. (From Reider B. The Orthopedic Physical Examination. Philadelphia, Saunders, 1999, p 367.)
Back Pain Revealed

Back Pain Revealed

Tired Having Back Pains All The Time, But You Choose To Ignore It? Every year millions of people see their lives and favorite activities limited by back pain. They forego activities they once loved because of it and in some cases may not even be able to perform their job as well as they once could due to back pain.

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